Duke laboratory researchers and physician-scientists are pursuing a wide range of research to improve care and outcomes for patients with melanoma and other skin cancers. Here are few highlights:

• Duke physicians use new surgical techniques for the treatment of malignant melanoma, include intraoperative lymphatic mapping and sentinel lymph node biopsy. This technique allows surgeons to remove a single lymph node to determine whether melanoma has spread from its primary site on the skin.
• Researchers at Duke have been instrumental in developing the role of positron emission tomography (PET) scanning in the staging of patients with malignant melanoma. This imaging technique allows physicians to pinpoint hot spots of melanoma that may have spread throughout the body and helps to distinguish benign from malignant tumors.
• Duke’s Pigmented Lesion Clinic and Melanoma Surveillance Program pioneered the use of CD-ROM technology to preserve a clear record of skin. Patients with numerous atypical (dysplastic) moles, personal history, or family history of melanoma are photographed from 33 different angles at the clinic. During future visits, the patient’s moles can be compared with the digital baseline images on the computer screen to discern if any changes took place since the last exam.
• Duke participates in numerous national clinical trials that attempt to define the importance of finding tumor cells so small they are detectable only with molecular biology techniques.
• Duke is exploring novel vaccine strategies involving dendritic cells to boost the immunity of patients with advanced disease.
• Duke researchers are studying a class of drugs called interferons that kill melanoma cells. They are also determining the genes involved in that process in order to identify new targets for treating melanoma.
• Duke researchers are studying the origin of melanoma and have determined that the original melanoma mutation may occur in an adult stem cell. Current efforts are focused on identifying markers for these cells that will allow for the development of new diagnostic and therapeutic approaches.
• Duke researchers are leading international efforts to develop novel ways to treat regionally advanced melanoma. Using new drugs and novel delivery systems, Duke has become one of the largest regional therapy treatment programs in the country and is actively involved in leading national trials designed to give chemotherapy to an arm or a leg to treat locally recurrent or regionally recurrent melanoma that is confined to the extremities. Various novel treatment protocols include giving a high dose of chemotherapy into the extremity in conjunction with either hyperthermia or new targeted drugs to make the high dose chemotherapy more effective. During these treatments, the limb’s circulation is cut off from the rest of the body, which helps to minimize the side effects of the treatment.